|
{ _ r"iSr��s ..1� , . . . . .
<br /> ' I ' � � � DOILDING PE?iMIT APPLICATTON � � ' � � ' � ' r� ,
<br /> - � .' ' � . : Applicant To Complete This :orm ' ' •/ �f�.�
<br /> : �
<br /> _ •�� Zf more than one bui2dinq is to be contructed, submit a separatc permit applica-
<br /> tion for each building. 11 seoarate permit will be issued Ear each buildinq.
<br /> . ' ' Omer f-�- n �)S � O��1"`�cr`; � S Buildin Address �y � � t0 I'��
<br /> � 4 O � n�.� �V�j<(-, iG� �
<br /> . ' . . aaaress R 4 7. I � I/ .Fl�('-,/�EErIIA�A�ae elx�: w � �
<br /> City �llE��Cl�"� Phone Subdivision (Plat) � '
<br /> � � lrchitect/Engineer - � •
<br /> _ . ;
<br /> •:� ' `_'� City Phone Metes s Bounds (Unplatted) •
<br /> - - i 1 �a-, . ..
<br /> :�' Coatractar ��_�� :\'i4.Sl�1�,�$��fl C;�;!r. Sec. 7� Twp. ZC/ Rge �1� .
<br /> . . , .
<br /> c . .• ' 3ddress � 70/ � �I�� 7� r" � � _ Z • ,
<br /> . ! City SC'n�1� � Phone A 2 �LI�0 Bailding Use S � � �
<br /> �- , AL F_, a �F/C°r��:�::-::
<br /> � rJ State,License xmnber 223-D1- �_y0D Deseribe Work to He Done �/FLf/• /� r�'' Y'
<br /> � : ,I Ezpiration Dat� R- 1 - 7S ' � � 171 f� .��d 4 IC ,4 S S�' "}'a`1 �7 �Gr
<br /> ���. ~ 4 ' SiCETCFi PLOT PLAN BELO�P' • -P V EG IC� �`l,�.I� I '1�' J O �I .-. '.
<br /> �' �J � ': - � � .
<br /> IIae of Building
<br /> { �
<br /> �� ; � � - ...�. . ' , � � � � []New f� Addition �Repair/P.emouel '
<br /> _ . '-� �. ., .
<br /> � , "`;. . . • • _ � Valnation of r_onstruction 5/�1 ;,1 t� �� � ,
<br /> o�. - � �� � � � � ` �
<br /> �+►- . -' � � . .. ' . � . ��1"� � PLOT PLAN REQUI?2EMENTS , . .
<br /> .y . .. . . ... . a
<br /> � .
<br /> � - :. t •� • `_ . ' ` � .' Indicate lot size, name of streets,
<br /> � ,. ' �indicate location and width of
<br /> i • alleys, locate pr000sed and all �
<br /> • .• � existing buildings, show distances
<br /> �', ; t - �� . - � : • to proF� ty lines, show distances
<br /> � , . � -. be�Freec. ruildinas.
<br /> �
<br /> � a, . .. '. . , c �" � 'YAt S1Z0 X
<br /> .- . � ' .-_1 Lot area Sq. Ft.
<br /> y • �, ' • ' �( Size of Bldg. <..� Sq. Ft_
<br /> �� � i :• Numher of Stories �
<br /> �i '.: . i Q Basemcnt N � - � .
<br /> • . _L , /
<br /> ,� t . Signed By �� ,1:,ci�'� / �- �.n.� �.int,+.
<br /> yi'
<br /> �. For W A �.-F E- 17 ti ;'� �. •,
<br /> .�� , • ' Owner Phone :" - /5 s
<br /> • '� .' ' •
<br /> . . ' DO NOT SC.2ITE B�LOI�7 THZS LI:IE-POR CITY USE OiJL'i � �
<br /> . Date ?:eceived 3 O �7S � Ace Zone
<br /> ' Ylaa Check :Iur,ber �-�"`�/ -�?�� Fire Zone � "
<br /> ✓ . .
<br /> Balnaticn f�-�LGJ� Occunancy Grou� ,_ =�
<br /> !�
<br /> Pemit Fee /5. �-� Type of Construction v - �-�
<br /> ,' Plan Check ?ee �/- �/ Occupant Load
<br /> , �, � ToWl Fee Due 2� �7 Sprinklers Required _ .
<br /> ., . —� .
<br /> Date issued � � '. , CITY OF E�!ERETT .
<br /> • • • • ' " APPROVGD FOR'BURDING PERMI.T: � '
<br /> . • _ • D'ate � rt �.--^� 1l"---i"'_.-�- , ' '
<br /> �_ � . ,+s "�,�Se �°.�ct.�a.�?u.'� ...
<br />
|